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KEY POINTS

KEY POINTS

Depression is a common and chronic disease that can cause serious harm to patients and increases the risk of death.

  • Treatment goals for depression include reduction or remission of current symptoms, return to a full level of functioning, and prevention of future depressive episodes and/or relapse.

  • Medications commonly used to treat depression include selective serotonin reuptake inhibitors (eg, sertraline), serotonin-norepinephrine reuptake inhibitors (eg, venlafaxine), bupropion, and tricyclic antidepressants (eg, amitriptyline).

  • MTM providers should educate patients and/or their support system (eg, family members) about the delay in onset of antidepressant effects.

  • Medication therapy management (MTM) providers should explain the importance of adherence throughout the entire course of antidepressant treatment.

  • MTM providers should advise care when patients are switching between antidepressants to avoid withdrawal symptoms and ensure a consistent therapeutic response.

  • Patients with depression should be assessed for suicide risk, and MTM providers should be familiar with supportive resources for patients expressing suicidal ideation (eg, National Suicide Prevention Lifeline 1-800-273-8255).

INTRODUCTION TO MAJOR DEPRESSIVE DISORDER

Recognizing Depression

Major depressive disorder (MDD) is characterized by discrete episodes of at least 2 weeks’ duration (although most episodes last considerably longer) involving clear-cut changes in affect, cognition, and neurovegetative functions, and interepisode remissions.1 According to criteria listed in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, a major depressive episode is defined by the criteria listed in Table 20-1.1

TABLE 20-1DSM-5 Diagnostic Criteria for Major Depressive Disorder

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